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Plot
At a psychiatric ward, therapist Rose Cotter meets graduate student Laura Weaver,[a] who explains that she recently witnessed her professor kill himself. Laura claims to be terrorized by an invisible entity that appears as various smiling people and has foretold her death. She begins screaming and choking, prompting Rose to call for help; Laura suddenly calms down and smiles uncannily, then fatally slits her own throat, terrifying Rose.
The next day, Rose sees a patient named Carl, who smiles in the same way and tells her that she is going to die. Rose calls for nurses to restrain Carl, only to realize Carl has been asleep the entire time. Concerned for Rose's mental well-being, her supervisor, Dr. Morgan Desai, orders Rose to take a week off. Rose's hallucinations continue, leading those around her to believe she may be a danger to herself. Rose visits her former therapist, Dr. Madeline Northcott, who suggests that Rose's problems stem from her childhood, in which she witnessed her abusive and mentally ill mother die from overdose.
Rose sees a toy train and buys it as a birthday present for her nephew, the son of her older sister Holly. At the party, he unwraps her present to find the corpse of Rose's cat, horrifying everyone. Rose has a public breakdown and sees a guest smiling unnaturally at her, causing her to fall into a glass coffee table and injure herself. This convinces Rose that she has fallen victim to a curse, although her fiancé Trevor believes she has gone crazy.
Upon learning that Laura's professor was smiling at her before his death, Rose visits the professor's widow, Victoria, and learns that he had also witnessed a suicide shortly before his own. Rose asks her ex-boyfriend Joel, a police detective, to review old police records. They find several cases of people who witnessed someone commit suicide while smiling at them before doing the same to themselves within a week.
Rose tries to patch things up with Trevor but realizes he has called on Madeline for psychological intervention without asking her first. Upset, she leaves to speak with Holly, who also dismisses Rose's belief in a curse. Holly compares Rose's behavior to their late mother, and Rose accuses Holly of abandoning her before their mother's death.
Rose and Joel discover the sole exception in the chain of suicides: convicted murderer Robert Talley. Rose and Joel visit him in prison, where he claims that the entity feeds on trauma and that the only way to escape it is to brutally kill someone else in front of a witness to traumatize them, passing the curse to the witness. Rose angrily rejects this idea. The entity appears at her home in Madeline's form and taunts her. Rose drives to her hospital with a knife and murders Carl in front of Morgan, but this is revealed to be a hallucination. Rose wakes up in her car to find Morgan standing outside. He notices the knife, but she speeds away, prompting him to alert the police.
Rose drives to her abandoned family home, realising the entity's curse ends with her if she dies alone. The entity appears as Rose's mother, and it is revealed that Rose could have saved her mother but chose not to. The entity attacks Rose, and a fire starts during the struggle, seemingly killing the entity. Rose flees the house and returns to Joel's apartment. Joel smiles at Rose, who realizes this is another hallucination.
In reality, Joel has tracked Rose's phone to her old house and finds her outside. Rose panics and runs back inside, where the entity reveals its true form; a skinless, semi-humanoid monstrosity with multiple sets of malformed jaws nesting within an enormous, smiling mouth. The sight of the entity's visage causes Rose to fall into a trance, and the entity possesses her. Joel breaks down the front door and sees a smiling Rose set herself on fire, passing the curse on to him.
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